MSK Flashcards
What is used to diagnose Duchenne’s, what is the clinical picture?
Genetic Analysis, raised CK
- calf hypertrophy
- Gowers sign +ve
- dilated cardiomyopathy
Management of Temporal Arteritis for someone with evolving vision loss?
IV Methylprednisilone
What should be measured in suspected drug induced lupus?
Anti-Histone antibodies
Treatment of choice for septic arthritis?
Flucloxacillin
Clindamycin for penicillin allergic
- Joint decompression/lavage
Finding on temporal artery biopsy in TCA?
skip lesions
Most common causative organism septic arthritis?
- Staph aureus UNLESS YOUNG Neisseria gonorrhoeae
When should Uric acid be rechecked gout?
2 weeks after gout has settled
What is the most common adverse effect of Hydroxychloroquine?
Bull’s eye retinopathy
What spondyloarthropathy is associated with IBD?
Enteropathic arthritis
3 important points about Aziathiopurine?
- Thiopurine methyltransferase activity needs to be tested before hand
- Major interaction with allopurinol
- Safe in pregnancy
Used instead of Bisphosphonates if eGFR< 35 or not tolerated?
Denosumab: inhibits RANKL so prevents development of osteoclasts
What needs to be performed before commencing biologic treatment?
CXR
Most likely blood finding in Paget’s disease?
Isolated raised ALP
Finding on x-ray for ankylosing spongylitis?
- Syndesmophytes;: ossification
- Sacroillitis
- Squaring of lumber vertebrae
What drug are patients with aspirin allergy/sulphonamide drug also likely to be allergic to?
Sulfasalazine
Name 4 side effects of sulfasalazine?
- Steven Johnson Syndrome
- Oligospermia
- Heinz body anaemia/Megaloblastic anaemia
- coloured tears
What do you manage acute flares of Rheumatoid Arthritis with?
IV or PO corticosteroids (Methylprednisolone/ Prednisolone)
How many NSAIDs have to be trialled in ankylosing spondylitis for anti TNF Treatment
2
What immunoglobin is found in breast milk
IgA
Proximal myopathy + Waddling gait=?
Osteomalacia
Most common tumour associated with diaphysis of the long bone?
Ewing’s
Where is Paget’s most likely to be?
Pelvis, Lumbar spine, Skull
What dermatological condition is associated with reactive arthritis?
Keratoderma Blenorrhagica
What is the main side effect of Colchicine?
Diarrhoea
What drug should be used in renal complications of systemic sclerosis?
ACEi
What is useful for monitoring an SLE flare?
Completent (LOW) anti dsDNA (high)
What condition (not rheum) is reactive arthritis strongly associated with?
IHD
Heart problem associated with Ehler-Danlos?
What collagen does it affect?
Aortic Regurgitation, mitral valve prolapse and aortic dissection
- Type 2
Azathioprine and Allopurinol can both cause what?
Severe bone marrow suppression
In Rheumatoid Hx of Psychiatric Disease?
SLE
What cancer are patients with Sjogren’s more at risk of?
Lymphoma
What atypical fracture is bisphosphonate associated with
?
Proximal femoral shaft
Associations of good prognosis in Rheumatoid Arthritis
Rheumatoid Factor Negative
